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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Date: May 2012


Recently, JH-IIRU director, Adnan Hyder and associate director, Kent Stevens, along with International Health assistant professor and associate director of the Center for Refugee and Disaster Studies, Courtland Robinson, traveled to Pakistan to participate in the Annual Emergency Medicine Conference (AEMC) at the Aga Khan University in Karachi.
The 2012 conference, “Emergency Medical Response in Disasters,” focused on medical response and community preparedness in natural and man-made disasters. Themes of the conference included foundations of disaster medical response, search and rescue operations, restoring health care systems, disaster research, and capacity development and use of technology for disaster medical response. The conference was designed to both examine issues from a Pakistani perspective and foster broader discussions on emergency response. This conference is co-organized by the Department of Emergency Medicine at Aga Khan University which is a WHO Collaborating Center for Emergency Medicine and Trauma Care.


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Panel discussion with (L to R) Adnan Hyder and Courtland Robinson at the AEMC.


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Adnan Hyder delivers a lecture at the AEMC.


For more information on the conference, click here:
http://www.aku.edu/aboutaku/newsandevents/aemc/Pages/home.aspx

For additonal information on the work of the International Injury Research Unit, email us at
IIRU@jhsph.edu.

Please join the Johns Hopkins International Injury Research Unit (JH-IIRU) as we congratulate our director, Adnan A. Hyder, on his promotion to full professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

Dr. Hyder has been a leader in injury research for more than 20 years. He is well-known for his work on burden of disease and injury measures, for developing the healthy life year indicator, and building on the health systems approach to injury prevention and control in developing countries.

In 2010, under Hyder’s leadership, JH-IIRU joined the Bloomberg Global Road Safety Program, a $125 million effort to reverse global deaths and injuries from road traffic crashes.  Dubbed the
Road Safety in 10 Countries Project (RS-10), JH-IIRU is responsible for the ongoing monitoring and evaluation of the road safety interventions in all 10 countries, as well as the development of training materials for health care workers. That same year, Hyder and the IIRU team received the status of World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention designation. JH-IIRU is only the third collaborating center in the United States to focus on injury prevention, and joins a network of more than 800 WHO Collaborating Centers in more than 80 countries. Recently, the JH-IIRU published a special issue of Traffic Injury Prevention which highlights new and aggregate data collected and analyzed in the 10 participating countries during the first two years of the RS-10 project.

Dr. Hyder is the current Chairman of the global Road Traffic Injuries Research Network (
www.rtirn.net) and a member of the International Organizing Committee of the World Conferences on Injury Prevention and Safety Promotion. He was the former President of the International Society for Child and Adolescent Injury Prevention, Research Ambassador for the Paul Roger’s Society for Global Health, and recipient of both the IRTE/Prince Michael Award for Road Safety and the American Public Health Association-International Health Section Career Awards. Dr. Hyder received his MD from Aga Khan University, Pakistan and obtained his MPH and PhD in Public Health from Johns Hopkins Bloomberg School of Public Health.  In addition to leading the JH-IIRU, Dr. Hyder is the Deputy Director of the Health Systems Program and an Associate Director of the Berman Institute of Bioethics.

In a recently published article, Johns Hopkins International Injury Research Unit (JH-IIRU) and collaborators from the Department of Emergency Medicine at Aga Khan University (DEM-AKU) examine unintentional childhood home injuries in Karachi, Pakistan. JH-IIRU director, Adnan Hyder and AKU-DEM director, Junaid Razzak amongst other colleagues participated in this surveillance study.
The article, “Understanding Unintentional Childhood Home Injuries: Pilot Surveillance Data from Karachi, Pakistan,” which appears BMC Research Notes, analyzed results of a previous pilot surveillance study done on unintentional childhood injuries presenting to emergency departments in both public and private hospitals in Karachi. Their findings revealed that of the approximately 400 injuries that occurred in the home, falls made up the majority at 59%, followed by dog bites, burn injuries and road traffic injuries. Most of these injuries occurred during play time. Fifty-four percent of the children were between 5-11 years old and 41% were between 1-4 years old.
This kind of analysis not only helps to define the kinds of unintentional injuries that are most prominent among hospitals in a particular area, but also help researchers concentrate intervention and control strategies, such as defining and adhering to building standards for homes, controlling stray dogs and installing traffic calming measures in residential areas.
Like JH-IIRU, the Department of Emergency Medicine at Aga Khan University (DEM-AKU) is a World Health Organization Collaborating Center for Emergency Medicine and this collaborative project represents collaborating centers working together to better understand the burden of injuries in low income countries.
To access this article, click here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337295/?tool=pubmed
To find out more about unintentional childhood injuries, contact us at
IIRU@jhsph.edu

With an estimated 1.2 million people dying in each year, road traffic crashes are a serious, but sadly, often overlooked disease burden around the world. This burden is more severe in low- and middle-income countries, where road traffic fatality rates are double what they are in developed countries.
To address this burgeoning trend, in 2010 and with funding from Bloomberg Philanthropies, the Johns Hopkins International Injury Research Unit (JH-IIRU) joined a consortium of six partners in the
Road Safety in 10 Countries Project (RS-10), a five-year initiative dedicated to reducing the burden of road traffic injuries in ten low- and middle-income countries by evaluating and implementing road safety solutions in places where interventions are needed the most.
The goal of the project is simple: save lives by providing evidence for stronger road safety interventions around the world. But the IIRU team can’t accomplish this goal alone. In order to be effective, they depend on local personnel in each country to not only help develop strong ties within each targeted community, but to conduct evaluations and collect data at each site. To that end, the JH-IIRU team has created a training and capacity development component of the RS-10 project.
Since the project’s inception, and through a program built on a country-specific mission, a sound public health approach, and scientific rigor, the JH-IIRU addresses the basic sciences of public health, a social science component, and health systems analysis with a special focus on ethical and cultural issues. JH-IIRU has developed and employed a concerted, three-pronged strategy for capacity development comprising of 1) Learning by doing 2) Courses and 3) Workshops.
Led by JH-IIRU Associate Director, Abdulgafoor M. Bachani, in the first two years of the program these three approaches have yielded impressive results and continue to do so. In each country, JH?IIRU collaborates with local research groups or universities to facilitate data collection for monitoring and evaluation. In this learning by doing approach, the JH-IIRU staff trains local collaborators for data collection through activities such as observational studies, road-side interviews, database creation and data analysis, to name a few.  

 
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Participants learning how to conduct observational studies in Cambodia.

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Helmet use observational study.


The important results of this work are showcased in the special issue of the journal
Traffic Injury Prevention.


Building on existing coursework at JHSPH, JH-IIRU has also developed and modified courses specific to the global burden of road traffic injuries. Working to create live (in-person) and online versions of many of their offerings, the team offers a sequence of four courses to comprise an innovative program in Road Traffic Injury Prevention and Control. These courses combine the expertise at JH-IIRU with the specific local needs of participating countries. Free access to course materials for two of the courses via the OpenCourseWare (OCW) system at JHU is already
available, while the remaining two classes will be made available shortly. This long-distance learning option makes effective training for health and allied professionals in each country possible.
Finally, since 2010, the JH-IIRU has conducted workshops in each of the 10 countries, which have been tailored to meet local needs. More than 445 individuals from each country have been trained in topics ranging from data collection and management, to evaluation methods for road safety, to handing of data for injury surveillance. Recently, members of the JH-IIRU team hosted workshops in Phnom Penh, Cambodia. The National Workshop on Evaluation Methods for Road Safety focused on topics such as evaluation designs, data collection methodologies, database creation and management, data analysis, and dissemination of findings, while at the same time provided an opportunity for cross-country collaboration.
In an article which appeared in Cambodia’s Koh Sentepheap newspaper, attendee H.E. Mr. Peou Maly, Deputy Secretary General of General Secretariat of the National Road Safety Committee, applauded the workshop, saying he firmly believed it would contribute to efforts of the Royal Government of Cambodia in reducing the number of road crashes.

 
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Participants register for a training workshop.


In Kenya, JHU-IIRU held a training workshop in March to train Naivasha district hospital data collectors and hospital administrators on the data collection for the trauma registry.  

 
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An example of a trauma registry form, Naivasha Hospital

And in Russia, JHU-IIRU held workshops in February and March 2012.  Seventy professors and data collectors from Ivanovo University were trained to conduct both observational studies and roadside surveys on seatbelt use and speeding during a two- day workshop.  A three-day workshop to address data gaps in surveillance and registry systems was attended by 40 representatives from the Ivanovo Ministry of Health, Lipetsk Ministry of Health, Ivanovo Regional Accident and Trauma Centre, and Lipetsk Regional Accident and Trauma Centre.  Members of the Lipetsk Regional Accident and Emergency Trauma Centre indicated that the data collection approach they learned will help them not only to build their own data collection system for collecting and reporting the data within the RS-10 project, but also help to improve their own data collection processes in their daily work.  It is vital, attendees said, to have their daily data collection work verified with police in order to ensure the quality of the collected data.
 

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Attendees at a workshop in Ivanovo, Russia  

In addition to these in-country workshops, JH?IIRU has also facilitated cross-country learning through a special session at the Safety 2010 World Conference on Injury Prevention and Safety Promotion in London, and a collaborators workshop in Baltimore in October 2011. These workshops made possible important cross?country discussions on data collection strategies, standardizing methods across countries, and challenges as well as planning for more effective evaluation strategy in each country. Based on the success of these sessions, JH-IIRU is exploring hosting a scientific session on RS?10 at theWorld Conference on Injury Prevention and Safety Promotion in New Zealand, 2012.

Training and capacity development is a vital part of the RS-10 project that will help ensure in-country collaborators, partners and researchers are an integral and effective part of the projects efforts to reduce the growing burden of road traffic injuries worldwide.
To find out more, please contact us at
IIRU@jhsph.edu

Members of the Johns Hopkins International Injury Research Unit (JH-IIRU), including director, Adnan Hyder and associate director, Aruna Chandran, along with colleagues from Aga Khan University (AKU) in Pakistan, recently published a paper in the International Journal of Pediatrics.
The article, titled, “Childhood Unintentional Injuries: Need for a Community-Based Home Injury Risk Assessment in Pakistan,” addresses the dearth of printed materials about home injury prevention in low- and middle-income countries (LMICs) as compared to the availability of comparable information in  high income countries (HICs). The paper also examines the development of two tools for home hazard reduction: an in-home tutorial and an educational pamphlet in preparation for a proposed study, the Global Childhood Unintentional Injury Surveillance-Phase 2, Pakistan (GCUIS-Pak). The GCUIS-Pak would test the implementation and acceptability of the tools in two neighborhoods in Pakistan’s largest city, Karachi. 
Additionally, the GCUIS-Pak is part of ongoing collaborative efforts between the Johns Hopkins Bloomberg School of Public Health/International Injury Research Unit and Aga Khan University/Department of Emergency Medicine in Pakistan. In 2005, JHU-IIRU partnered with Aga Khan University in the development of a child injury surveillance project that resulted in the development of a system with great potential for developing countries, supported by the Department of Violence and Injury Prevention at the World Health Organization, Geneva (published in 2009 –
Hyder AA et al).  The program also hopes to raise awareness about the importance of child injury and trauma research and foster collaboration among health professionals and researchers in Pakistan, while establishing linkages and partnerships with the broader international injury research community.
To access the paper,
click here.
To find out more about the ICTIRT or other JH-IIRU collaborative efforts , contact us at
IIRU@jhsph.edu

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